Your UMP vision benefits
Vision coverage is provided by UMP, in collaboration with Regence Choice
Vision Plan administered by Vision Service Plan (VSP). Get the most out of your
UMP vision benefits and save money with a VSP Choice network provider. To
learn more about your vision coverage, check your plan’s 2024 certificate of
coverage by visiting forms and publications at hca.wa.gov/ump-pebb-coc.
Benefit Frequency
Your cost with a
VSP Choice network provider
Your cost with an
out-of-network provider
Professional
comprehensive
routine eye
exams
One per
calendar year.
You pay $0 of the allowed amount
and the plan pays 100% of the
allowed amount.
You pay 100% of billed charges.
VSP will reimburse you up to
$45 when you submit a claim for
a covered exam.
Frames One every two
calendar years.
You pay $0 up to a $150 frame
allowance; or
You pay $0 up to an $80 frame
allowance for Walmart®,
Sam’s Club®, or Costco® providers.
You pay 100% of billed charges.
VSP will reimburse you up to
$70 when you submit a claim for
covered frames.
Lenses and
enhancements
One set every two
calendar years.
You pay $0 for the following
covered lenses and the plan pays
100% of the allowed amount:
• Single vision lenses
• Lined bifocal lenses
• Standard progressive lenses
• Lined trifocal lenses
• Lenticular lenses
Note: Lens enhancement is not
covered except for impact-resistant
coating for dependent children
ages 19 and over.
You pay 100% of billed charges.
VSP will reimburse you up to the
following amounts when you submit
a claim for covered lenses:
• $30 single vision lenses
• $50 lined bifocal lenses
• $50 standard progressive lenses
• $65 lined trifocal lenses
• $100 lenticular lenses
Contacts One set of
contact lenses
or disposable
contact lenses up
to the maximum
allowance
instead of frames
and lenses every
two calendar
years.
You pay a $30 copay for contact
lens evaluation and fitting exam.
You pay $0 up to a $150 contact
allowance for elective contact lenses.
You pay $0 for necessary
contact lenses. Note: You are still
responsible for paying a $30 copay
for the contact lens evaluation and
fitting exam.
You pay 100% of billed charges.
VSP will reimburse you up to the
following amounts when you submit
a claim for contact lenses:
• $105 for elective contact lenses
• $210 for necessary contact lenses
The below VSP coverage table applies to adults and dependents ages 19 and over.
Note: Please see your plan’s UMP certificate of coverage for reimbursement rates for vision services received outside the U.S.
Have questions for VSP?
Call VSP Member Services at
1-844-299-3041. Deaf, DeafBlind,
Late Deafened and Hard of Hearing
members call (TTY): 1-800-428-4833.
Benefit Frequency
Your cost with a
VSP Choice network provider
Your cost with an
out-of-network provider
Professional
comprehensive
routine eye
exams
One per
calendar year.
You pay $0 of the allowed amount
and the plan pays 100% of the
allowed amount.
You pay 100% of billed charges.
Frames One per
calendar year.
You pay $0 of the allowed amount
and the plan pays 100% of the
allowed amount.
You pay 100% of billed charges.
Lenses and
enhancements
One set per
calendar year.
You pay $0 for the following
covered lenses and the plan pays
100% of the allowed amount:
• Single vision lenses
• Lined bifocal lenses
• Standard progressive lenses
• Lined trifocal lenses
• Lenticular lenses
You pay $0 for the following lens
enhancements and the plan pays
100% of the allowed amount:
• Scratch-resistant coating
• Ultraviolet (UV) protected lenses
• Impact-resistant coating
You pay 100% of billed charges.
Contacts One set of
contact lenses
or disposable
contact lenses up
to the maximum
allowance
instead of frames
and lenses every
calendar year.
You pay $0 of the allowed amount
for elective or necessary contact
lenses and the plan pays 100% of
the allowed amount.
You pay $0 of the allowed amount
for contact lens evaluation and
fitting exam and the plan pays 100%
of the allowed amount.
You pay 100% of billed charges.
The below VSP coverage table applies to children under the age of 19.
Out-of-network providers are not covered for any routine vision services.
Note: Walmart®, Sam’s Club®, and Costco® providers are not VSP Choice network providers for children under the age of 19
for frames, lenses, and contact lenses. Call VSP Member Services at 1-844-299-3041 for out-of-network plan details. Deaf,
DeafBlind, Late Deafened and Hard of Hearing members call (TTY): 1-800-428-4833.
Frequently asked questions
Do members need an ID card?
As a UMP member with VSP coverage, you have a two-part
member ID on your UMP ID card. To learn more about your
eligibility, you will need to use the full ID number, which
includes all letters and numbers with no spaces. The last
two digits are the numbers next to your name. Example:
UDWW71234567800.
At your appointment with a VSP Choice network provider,
simply tell them you are a UMP member with vision coverage
through VSP and share your full UMP ID number. The
network provider and VSP will handle the rest.
Can I see my benefits online?
You can view your benefits by signing in to your Regence
account at ump.regence.com/ump/signin, selecting
View my benefits, Vision, then selecting Access Benefits.
If you choose to go to the VSP website at vsp.com directly,
have your UMP Member ID card handy. If you are logging in
for the first time, log in with your UMP Member ID number
(not your SSN). See the “Do members need an ID card?”
question above for more information about your complete
UMP Member ID.
What about retail?
All participating retail chains provide members the same
benefit experience they receive from a VSP Choice network
provider, with minor exceptions like the frame allowance at
Walmart®, Sam’s Club®, and Costco®; lens enhancements
covered with copay; and value-added benefits. The retail
frame allowance at Walmart®, Sam’s Club®, and Costco® is
$80 and discounts do not apply. As independent contractors,
not all providers at Walmart®, Sam’s Club®, and Costco®
are contracted as VSP Choice network providers for exam
services. Log in to the VSP website at vsp.com or call
Member Services at 1-844-299-3041 prior to seeking exam
services to confirm the provider’s network status. Deaf,
DeafBlind, Late Deafened, or Hard of Hearing members,
call (TTY): 1-800-428-4833.
How do I find a VSP Choice network provider?
You can search for a VSP Choice network provider for
preventive (routine) vision services through the VSP
website at vsp.com/eye-doctor by logging in to your
VSP account or by selecting Find a doctor and using the
advanced search option to select Choice for Doctor Network.
You can also search by signing in to your Regence account
at ump.regence.com/ump/signin, selecting Find care,
and selecting Vision, or call VSP Member Services at
1-844-299-3041. Deaf, DeafBlind, Late Deafened, or Hard
of Hearing members, call (TTY): 1-800-428-4833.
Can I buy prescription glasses or contacts online from a
VSP Choice network provider?
Yes. Adults and all dependents can use your benefits towards
prescription glasses and contacts on the Eyeconic® website
at eyeconic.com.
• Go to the Eyeconic® website at eyeconic.com and sign in
if you already have an Eyeconic® account.
• To create an account, go to the Eyeconic® website at
eyeconic.com and select Use My Insurance.
• Choose VSP in the dropdown menu and select Continue
• Select Sign in with VSP
• Enter a VSP username and password, then select Sign On
• Select the name of the person you want to shop for in the
drop down, then select Connect
• When you select a product, Eyeconic® shows you how
much of the retail price is covered by your vision benefits.
• Eyeconic® automatically applies a 20% discount to glasses
and sunglasses you purchase even if you choose not to
apply your insurance benefit.
Regence BlueShield serves select counties in the state of Washington
and is an Independent Licensee of the Blue Cross and Blue Shield Association
Vision service plan (VSP) is a separate company that provides routine vision
benefits for Uniform Medical Plan (UMP) members administered by Regence.
REG-868586-23/08rep868586-22
© 2023 Regence BlueShield
How to submit a claim
Submitting claims for VSP Choice network providers:
There are no claim forms to complete when you see a VSP Choice network provider. Your provider will take care of it for you.
Submitting claims for out-of-network providers:
If you are a member and are age 19 or older and you see an out-of-network provider, you can submit the claim online
or by mail within 12 months of the date of service. When you submit a claim, attach an itemized receipt that includes the
following information:
• Doctor’s name or oce name
• Name of patient
• Date of service
• Each service received and the amount paid
To submit the out-of-network claim online, visit the VSP website at vsp.com/claims/submit-oon-claim and select
“Start new claim.”
To submit a claim by mail, download the VSP Member Reimbursement Form by visiting the UMP commonly used forms
webpage at ump.regence.com/pebb/forms/common-forms or contact VSP Member Services at 1-844-299-3041 to request
a form. Deaf, DeafBlind, Late Deafened, or Hard of Hearing members, call (TTY): 1-800-428-4833. You must complete the
form and mail it to Vision Service Plan, Attention: Claims Services, PO Box 495918, Cincinnati, OH 45249-5918.
Note: There is no out-of-network benefit coverage for dependents under the age of 19.
Outside the U.S. and need to contact VSP Member Services or submit an out-of-country claim?
If you are outside the U.S. and need to contact VSP Member Services or submit a claim form for services received outside
the U.S., call 1-916-635-7373. Remember to dial the exit code of your country (typically 00) plus the country code (1 for
the U.S.), then the area code (916), then the seven-digit U.S. local phone number 635-7373. Example: 001-916-635-7373.
Deaf, DeafBlind, Late Deafened, or Hard of Hearing members, call (TTY): 1-916-851-1375 Example: 001-916-851-1375.
